DATE:
September 9, 2025
04
TO:
Board of Supervisors
SUBJECT
Title
SPARE WHEEL EXEMPTION REQUEST FOR SAN DIEGO COUNTY PERMITTED AMBULANCES (DISTRICTS: ALL)
Body
OVERVIEW
In San Diego County, the Emergency Medical Services (EMS) Office is the Board of Supervisors designated Local EMS Agency (LEMSA). The EMS Office is responsible for implementing State statutes and regulations specific to the emergency medical service delivery system in our region, including ambulance service. Title 13 of the California Code of Regulation governs the equipment and supplies required for ambulances and has been established for the health and safety of the public. Among equipment mandates of this section, there is a requirement for ambulances to carry a spare wheel and changing tools.
LEMSAs are authorized to issue an exemption to the spare wheel requirement, subject to approval by County Board of Supervisors. The San Diego County Board of Supervisors (Board) has been approving a spare wheel exemption for over 20 years. On October 19, 2021 (12), the Board approved an exemption for three agencies to increase space in ambulances for critical medical equipment. The EMS Office engaged with ambulance operators to determine if additional exemptions were needed. The three same operators formally requested the exemption to continue providing additional space for medical supplies and critical intervention equipment. Today's actions request a continued exemption from the spare wheel requirements for ambulance service providers operating in San Diego County effective on the date of approval formally given by the California Highway Patrol (CHP). Due to state regulations, this exemption is limited to a period of two years.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Approve, for good cause and because the exemption is necessary for public health and safety, the action to request from the Department of California Highway Patrol (CHP), an exemption from the ambulances spare wheel and tools requirements, for a period of two years once effective, as outlined in California Code of Regulation, Title 13, Section 1103 Ambulance Emergency Care Equipment and Supplies, for the following three ambulance agencies:
* American Medical Response (AMR)
* Mercy Medical Transportation, Inc.
* Falck Mobile Health Corporation
2. Authorize the Clerk of the Board of Supervisors to forward the Board's request for exemption to the Department of California Highway Patrol's Enforcement Services Division.
EQUITY IMPACT STATEMENT
Today's request for a spare wheel exemption removes barriers for ambulance service providers and allows critical additional space in ambulances for vital lifesaving medical equipment and interventions. This leads to better medical outcomes for residents needing ambulance transportation services across the region.
SUSTAINABILITY IMPACT STATEMENT
The spare wheel exemption request supports the County's Sustainability Initiative of protecting the health and wellbeing of everyone in the region by ensuring ambulance service providers have increased space for critical medical equipment.
FISCAL IMPACT
There is no fiscal impact associated with the requested actions. There is no change to the net General Fund Cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
N/A
BACKGROUND
The San Diego County Emergency Medical Services (EMS) Office, a division of San Diego County Fire, serves as the region's Local EMS Agency (LEMSA), as identified by Board Policy K-12 under California Health and Safety Code 1797.200. The EMS Office is responsible for providing medical direction and managing the region's emergency medical service delivery system, including inspecting and certifying private ambulance operators. In addition to creating local policies, the EMS Office enforces California statute and regulations that are specific to the emergency medical services delivery system.
Title 13, Section 1103 Ambulance Emergency Care Equipment and Supplies of the California Code of Regulations, requires safety equipment carried or installed in an ambulance, to be maintained in good working order, including a spare wheel along with the tools required to change a wheel and or tire. Upon assessment and with good cause, Section 1108 Exemption from Requirements of the California Code of Regulation, allows a private ambulance agency to request an exemption from carrying certain mandatory equipment and or supplies. The ambulance agency must first make the request through their LEMSA, which assesses the need for the exemption. If the LEMSA determines a good cause exists for granting the ambulance agency the exemption, then the LEMSA will submit the request to the California Highway Patrol (CHP) for approval, once authorized to do so by the LEMSA's governing board, in San Diego County's case, the San Diego County Board of Supervisors (Board). The CHP is authorized to approve a spare wheel exemption for a period of two years.
On October 19, 2021 (12), the Board, approved the spare wheel exemption for three agencies. This practice has been approved by the Board since 2005. The EMS Office recently engaged with private ambulance operators and received three requests for spare wheel exemptions. Those requests have been determined to meet an exemption from the spare wheel requirement and are warranted for public health and safety reasons. In lieu of a spare wheel, that space within an ambulance can be utilized to carry additional vital medical supplies and equipment necessary for patient care. Should an ambulance experience a flat tire, the closest available back-up ambulance is dispatched, minimizing delay in the transport of a patient.
Today's action requests Board authority to apply for a spare wheel exemption to the CHP for the following three ambulance service providers operating in San Diego County:
* American Medical Response (AMR), Inc.
* Falck Mobile Health Corporation
* Mercy Medical Transportation, Inc.
If the Board grants authority to request this exemption from the State, the Clerk of the Board of Supervisors will request the CHP approve the two-year exemption for the three agencies.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
By ensuring that the County's EMS System is capable of responding to the immediate needs of individuals and families without sacrificing safety standards, today's proposed actions support the Community and Sustainability Initiatives of the County of San Diego's 2025-2030 Strategic Plan.
Respectfully submitted,
EBONY N. SHELTON
Chief Administrative Officer
ATTACHMENT(S)
N/A
SUBJECT:
SPARE WHEEL EXEMPTION REQUEST FOR SAN DIEGO COUNTY PERMITTED AMBULANCES (DISTRICTS: ALL)
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COUNTY OF SAN DIEGO
AGENDA ITEM
BOARD OF SUPERVISORS
PALOMA AGUIRRE
First District
JOEL ANDERSON
Second District
TERRA LAWSON-REMER
Third District
MONICA MONTGOMERY STEPPE
Fourth District
JIM DESMOND
Fifth District
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